CostEffectiveness Analysis of Cancer Screening

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Cost-Effectiveness Analysis of Cancer Screening

• Martin L. Brown, Ph.D.
• Health Services and Economics Branch
• Applied Research Program
• Division of Cancer Control and Population
  Sciences
• International Breast Cancer Screening Network
• Biennial Meeting
• May 12, 2006

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What is Cost-Effectiveness Analysis

• Incremental Cost-Effectiveness Ratio (Cs C
  ns)/(Es Ens)
• Cs system costs with screening
• C ns system costs without screening
• Es health effects with screening
• Ens health effects without screening

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Special Considerations for Screening

• Costs
• Costs of recruitment, diagnostic follow-up,
  surveillance, quality control
• Time costs of participants
• Over-diagnosis
• Effects
• Quality of life (screening vs. disease/treament)
• Rare but serious adverse events
• General
• Long time horizon of costs and effects

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Special Considerations for Cross-National Studies

• Differences in age-specific cancer incidence, age
  distribution and life-expectancy
• Differences in health effects with and without
  screening (e.g. availability of follow-up and
  treatment)
• Differences in resource patterns and unit costs
• Differences in organization of healthcare and
  public health system, including feasibility of
  conducting screening
• Differences in overall level of national wealth
  and level of medical/public health resources.